American Mistletoe - Actemra (Tocilizumab) Interaction
Herbal: American Mistletoe
Also Known As: Phoradendron leucarpum, Eastern Mistletoe
Drug: Tocilizumab
Brand names:
Actemra
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jun 15, 2025
Interaction Details
There were no interactions found between Tocilizumab and American Mistletoe. This does not mean the potential for an interaction does not exist, however. There is often a lack of studies and data surrounding traditional medicine, especially concerning drug interactions, so it is important to always consult your provider before making any changes to your medication regimen.
American Mistletoe Overview
American mistletoe, scientifically known as Phoradendron leucarpum, is a parasitic plant found in the eastern United States and Mexico. It grows on hardwood trees like oaks and hickories. Although it has been used in traditional Native American medicine, there isn't strong scientific evidence for its effectiveness.
American mistletoe contains phoratoxin, a compound that can be toxic. This toxin induces smooth muscle contraction, leading to increased uterine and intestinal motility, which can result in gastrointestinal symptoms. Additionally, it can cause vasoconstriction, leading to changes in blood pressure and heart rate, similar to the effects of cardiotoxins found in cobra venom.
Most case reports documenting ingestion suggest that eating up to 20 berries or 5 leaves is unlikely to cause serious harm, but there are reports of fatalities from cardiovascular collapse after drinking tea made from an unspecified amount of berries.
It's important to note that American mistletoe is different from European mistletoe, which is more commonly used in dietary supplements.
Tocilizumab Overview
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Tocilizumab injection is used alone or in combination with other medications to relieve the symptoms of certain types of arthritis and other conditions including:
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rheumatoid arthritis (a condition in which the body attacks its own joints, causing pain, swelling, and loss of function) in adults who have not been helped by other disease-modifying antirheumatic drugs (DMARDs),
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giant cell arteritis (a condition that causes swelling of blood vessels, especially in the scalp and head) in adults,
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systemic sclerosis-associated interstitial lung disease (SSc-ILD; also known as scleroderma-associated ILD: a lung disease that involves scarring of the lungs) in adults,
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polyarticular juvenile idiopathic arthritis (PJIA; a type of childhood arthritis that affects five or more joints during the first six months of the condition, causing pain, swelling, and loss of function) in children 2 years of age or older.
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systemic juvenile idiopathic arthritis (SJIA; a condition in children that causes inflammation in different areas of the body, causing fever, joint pain and swelling, loss of function, and delays in growth and development) in children 2 years of age or older,
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cytokine release syndrome (a severe and possibly life-threatening reaction) in adults and children 2 years of age or older after receiving certain immunotherapy infusions.
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Tocilizumab injection is in a class of medications called interleukin-6 (IL-6) receptor inhibitors. It works by blocking the activity of interleukin-6, a substance in the body that causes inflammation.
American Mistletoe - More Interactions
American Mistletoe interacts with 187 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Drug descriptions are provided by MedlinePlus.
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Dr. Brian Staiger, PharmD
In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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